20 C.F.R. § 404.1527

Law changed since SSA’s August 1, 1991 revision moved § 404.1527 to evaluation of medical opinions, so its earlier consultative-examination rule is historical; Since March 27, 2017, § 404.1527 applies to claims filed before that date; § 404.1520c governs evaluation of medical opinions for later claims (82 FR 5844).

Section 404.1527 gives the Secretary authority to compel a claimant to undergo a physical or mental examination when the Secretary deems it necessary, but does not require the Secretary to provide an examination at the claimant's request.

McGee v. Weinberger · filed 1974-12-16

Apparently the plaintiff misconstrues the purpose of 20 C.F.R. § 404.1527. That regulation gives the Secretary the right to compel a claimant to submit to physical or mental examination by a physician designated by him if he deems such an examination necessary. It does not obligate the Secretary to provide such an examination at the claimant’s request.

Law changed since Same change as noted above.

Section 404.1527 requires a consultative physical or mental examination before disability can be denied when the record is insufficient and a qualified examination is needed to resolve unexplained pain.

Davis v. Joseph A. Califano, Jr., Secretary of Health, Education, and Welfare · filed 1979-07-25

Having accepted that Mrs. Davis was suffering from unexplained pain, the administrative law judge could not simply deny the claim without obtaining a consultative examination by a psychiatrist pursuant to 20 C.F.R. § 404.1527.

Law changed since Same change as noted above.

Section 404.1527 authorizes an administrative law judge to direct a claimant to undergo a medical examination at government expense when the record lacks adequate information about the duration of disability.

Memoli v. Califano · filed 1978-12-21

If in reviewing the record the ALJ did not feel that he had adequate information to determine how long Memoli continued to be disabled, he... could have directed that the claimant submit to a medical examination at the government’s expense. 20 C.F.R. § 404.1527.

Law changed since Same change as noted above.

Section 404.1527 permits a consultative examination when the record lacks sufficient facts for an informed disability decision and the examination is necessary.

Bowman v. Califano · filed 1980-01-07

The Court cited 20 C.F.R. § 404.-1527 which provides for consultative examinations where warranted. ... The record does not establish that a consultative examination is necessary to enable the Administrative Law Judge to make the disability decision. Therefore, the Secretary’s decision in this regard is supported by substantial evidence.

Law changed since Same change as noted above.

Section 404.1527 requires reasonable notice of the time and place of consultative examinations and an opportunity to show good cause for failing to attend before benefits may be denied on that basis.

Wade v. Harris · filed 1980-09-19

In summary, there is no substantial evidence that plaintiff had reasonable notice of the time and place of the examinations or that he did not have “good cause” for failing to appear. Thus there is no substantial evidence to support a denial of benefits pursuant to 20 C.F.R. § 404.1527. Under these circumstances, we must remand to the Secretary so that new consultative examinations can be given and a decision can be made on the merits of plaintiff’s claim.

Law changed since Since March 27, 2017, § 404.1527 applies to claims filed before that date; § 404.1520c governs evaluation of medical opinions for later claims (82 FR 5844).

Section 404.1527(d) treats statements that a claimant is disabled or unable to work as opinions on issues reserved to the Commissioner, not medical opinions entitled to special significance.

Ricci v. Berryhill · filed 2020-11-30(d)

While it would have been better if the ALJ had discussed Dr. Shappard’s statement, it consists of five sentences, the first two of which state background facts and the last of which is merely a formal pleasantry. Otherwise, he says Petitioner “has been medically unable to work … since 2003” and that “[t]his is a medical disability.” Neither assertion is a diagnosis, medical finding, assessment of functional limitation, or the like. Both assertions relate only to matters reserved to the Commissioner of Social Security. As such, per 20 C.F.R. 404.1527(d), they are not “medical opinions” and they are not entitled to “any special significance.” There is no error.

Law changed since Same change as noted above.

Section 404.1527(d)(1) provides that an ALJ need not give controlling weight to a treating physician’s opinion on the ultimate issue of disability.

Vincent v. Saul · filed 2020-12-22(d)(1)

Moreover, an ALJ is not required to give controlling weight to a treating physician’s opinion on the ultimate issue of disability. 20 C.F.R. § 404.1527(d)(1).

Law changed since Same change as noted above.

Section 404.1527(d)(1) and (3) treats whether a claimant is disabled as an issue reserved to the Commissioner, making a medical source's opinion on that ultimate issue a valid ground for rejection.

Lybarger v. Commissioner of Social Security Administration · filed 2021-03-29(d)(1) & (3)

First, the ALJ discounted Guinn-Lahm’s statement on the ultimate issue of disability because that is an issue reserved to the Commissioner. (AR 23.) Lybarger does not contest this portion of the ALJ’s finding, and it was a germane reason to reject that portion of the opinion. See 20 C.F.R. § 404.1527(d)(1) & (3).

Law changed since Same change as noted above.

Section 404.1527(d)(1) makes a medical source’s statement that a claimant is disabled or unable to work nonbinding on the agency’s disability determination.

Cash v. Commissioner of Social Security · filed 2021-07-14(d)(1)

see 20 C.F.R. §§ 404.1527(d)(1), 416.927(d)(1) (“A statement by a medical source that you are ‘disabled’ or ‘unable to work’ does not mean that we will determine that you are disabled.”). The ALJ accordingly did not err by discounting that portion of Ms. Sterchi’s opinions.

Law changed since Same change as noted above.

Section 404.1527(e) treats a medical source’s statement that a claimant is disabled or unable to work as an issue reserved to the Commissioner, not as a medical opinion, but it does not permit an ALJ to reject the source’s other assessed limitations without additional reasons.

(SS) Moy v. Commissioner of Social Security · filed 2021-10-08(e)

The ALJ is of course correct that the determination of whether a claimant is disabled is reserved for the Commissioner, and statements “by a medical source that [a claimant] is ‘disabled’ or ‘unable to work’ “ “are not medical opinions.” 20 C.F.R. §§ 404.1527(e), 416.927(e). ... Nonetheless, the ALJ’s right to ignore Dr. Bangalore’s legal conclusions regarding disability did not entitle her to discredit all Dr. Bangalore’s assessed limitations without further rationale.

Law changed since Same change as noted above.

Section 404.1527(d)(1)-(3) treats opinions on administrative findings as non-medical opinions and gives no special significance to opinions on issues reserved to the Commissioner.

(SS) Watson v. Commissioner of Social Security · filed 2022-03-11(d)(1)-(3)

While the court recognizes that the fact that a physician opines as to the ultimate issue of disability is not a sufficient reason to discredit their opinion, here Dr. Epperson does not provide functional limitations, and so the opinion on the ultimate issue of disability is the only opinion provided. The ALJ is not required to accept Dr. Epperson’s opinion on the ultimate issue of disability. See 20 C.F.R. § 404.1527(d)(1)-(3) (Opinions on administrative findings are not medical opinions and “we will not give any special significance to the source of an opinion on issues reserved to the Commissioner”).

Law changed since Same change as noted above.

Section 404.1527(d)(1) treats a medical source’s statement that a claimant is disabled or unable to work as nonbinding on the disability determination, while subsection (d)(2) addresses medical-source opinions about the nature and severity of the claimant’s impairments.

Black v. Social Security Administration, Commissioner · filed 2022-03-15(d)(1), (d)(2)

However, a “statement by a medical source that [a claimant is] ‘disabled’ or ‘unable to work’ does not mean that [the ALJ] will determine that [the claimant is] disabled.” 20 C.F.R. § 404.1527(d)(1). Instead, the ALJ “use[s] medical sources . . . to provide . . . opinions, on the nature and severity of [the plaintiff’s] impairment(s).” 20 C.F.R. §404.1527(d)(2).

Law changed since Same change as noted above.

A treating physician’s bare statement that a claimant is disabled is not a medical opinion entitled to special significance or evaluation under the treating-source factors.

Rattler v. Commissioner of Social Security · filed 2020-03-30(d)(3)

Dr. Varghese’s September 2016 statement to the Township Trustee only states, without any explanation or supporting evidence, that Plaintiff is disabled. While Dr. Varghese’s statement may have been useful to the Township Trustee in assessing Plaintiff’s qualifications for assistance, it does not qualify as a medical opinion no matter what the ALJ may have thought. As such, the ALJ’s failure to discuss all of the Section 1527(c) factors as part of her analysis in support of discounting Dr. Varghese’s “opinion” is not a sufficient reason - standing alone – to justify remand.

Law changed since Same change as noted above.

Section 404.1527 does not make a physician’s opinion that a claimant is disabled or unable to work determinative of disability.

Sherrer v. Secretary of Department of Health & Human Services · filed 1983-12-22

This duty is not inconsistent with 20 C.F.R. § 404.1527 (1983), which was relied upon by the ALJ, and which notifies a claimant that "a statement by your physician that you are ‘disabled’ or ‘unable to work’ does not mean that we will determine that you are disabled.”

Law changed since Same change as noted above.

Section 404.1527 provides that a physician’s conclusion on whether a claimant is disabled is not binding on the Secretary.

Meyers v. Heckler · filed 1985-11-12

Of course, the conclusions of a plaintiff’s physician on the ultimate issue of disability are not binding on the Secretary. 20 C.F.R. § 404.1527 (1985).

Law changed since Same change as noted above.

Section 404.1527 does not require the Secretary to accept a treating physician’s opinion on the ultimate legal issue of whether the claimant is disabled.

Pagan v. Heckler · filed 1985-04-01

The Secretary, however, is not bound by Dr. Vazquez’s use of the word "disabled.” Because "disability” is a term of art with a narrow definition under the Social Security Act, the responsibility for deciding the ultimate issue of disability is the Secretary’s.

Law changed since Same change as noted above.

Section 404.1527 provides that a medical source's opinion that a claimant is disabled is not binding on the ALJ.

Taylor v. Heckler · filed 1984-08-17

Nor is Dr. Saunders’ opinion—that plaintiff is disabled—binding on the AU.

Law changed since Same change as noted above.

A physician’s conclusion that a claimant is disabled is not controlling.

Fitzpatrick v. Heckler · filed 1986-06-17

It is settled law, however, that a physician’s conclusion concerning disability is not controlling.

Law changed since Same change as noted above.

The regulation permits the agency to discount a treating physician’s disability opinion when it is conclusory or unsupported by objective medical evidence.

Joyce M. JOHNS, Plaintiff-Appellant, v. Otis R. BOWEN, Secretary of Health and Human Services, Defendant-Appellee · filed 1987-07-14

The opinion of the treating physician regarding disability or inability to work may be discounted if it is unsupported by objective medical evidence or is merely conclusory. ... In this case, the ALJ had good cause for not according substantial weight to Dr. Ross’ statements concerning Johns’ inability to continue working because all three statements were conclusory and unsupported by objective medical findings.

Law changed since Same change as noted above.

A physician's statement that a claimant is disabled or unable to work is not determinative; the Secretary must evaluate the medical findings and other evidence supporting it.

Nance v. Louis W. Sullivan, Secretary of Health and Human Services · filed 1992-02-19

As the Appeals Council points out, such opinions are not determinative of the issue of disability; the Secretary is required to evaluate the medical findings and other evidence that support such a statement. Allen v. Weinberger, 552 F.2d 781, 785 (7th Cir.1977); 20 C.F.R. § 404.1527 ("[A] statement by your physician that you are 'disabled' or 'unable to work' does not mean that we will determine that you are disabled. We have to review the medical findings and other evidence that support a physician's statement that you are 'disabled.' " ) Dr. Hanaway's previous medical findings had been fully considered during the administrative process. No new findings were submitted with the February 1, 1989, assessment. Therefore, the Appeals Council did not err in refusing to give any further consideration to the assessment.

Law changed since Same change as noted above.

Section 404.1527(d) excludes a treating source’s opinion on the ultimate issue of disability from controlling weight.

Lately v. Colvin · filed 2014-03-26(d)

Thus, Dr. Magnuson’s opinion was not entitled to controlling weight because the issue of disability is not a medical opinion subject to controlling weight, see 20 C.F.R. §§ 404.1527(d), 416.927(d); SSR 96-5p, 1996 WL 374183, at *2 (July 2, 1996) (“[T]reating source opinions on issues that are reserved to the Commissioner are never entitled to controlling weight or special significance.”).

Law changed since Same change as noted above.

Under § 404.1527(d)(1) and (3), a medical source’s statement that a claimant is disabled or unable to work is an administrative finding reserved to the Commissioner, so it is not a medical opinion entitled to controlling weight or special significance.

Quisenberry v. Comm'r of Soc. Sec. · filed 2018-11-29(d)(1) and (3)

First, he noted that a doctor’s “statements that a claimant is ‘disabled’ or ‘unable to work,’ or the like, are not medical opinions but are administrative findings dispositive of a case, which can never be entitled to controlling weight.” Indeed, 20 C.F.R. § 404.1527(d)(1) and (3) now provide explicitly that no special significance will be given to the source of an opinion—such as whether a claimant is disabled or unable to work—reserved to the Commissioner of Social Security.

Law changed since Same change as noted above.

Section 404.1527(d) reserves the determination of whether a claimant meets the statutory definition of disability to the Commissioner.

Jones v. Commissioner, Social Secuirty Adminstration · filed 2019-08-27(d)

The court notes initially that the determination about whether a claimant has met the statutory definition of disability is reserved to the Commissioner. See 20 C.F.R. §§ 404.1527(d), 416.927(d).

Law changed since Same change as noted above.

Section 404.1527 reserves classification of a claimant’s residual functional capacity as “sedentary” to the Commissioner.

Melican v. US Social Security Administration, Commissioner · filed 2019-09-09(d)

Even if Welch’s sedentary designation could be considered a medical opinion, classification of an RFC as “sedentary” is an issue reserved to the Commissioner. See 20 C.F.R. § 404.1527.

Law changed since Same change as noted above.

Section 404.1527 treats a doctor's statement that a claimant is disabled or unable to work as not a medical opinion and therefore not entitled to controlling weight.

Thompson v. Social Security Administration, Commissioner · filed 2019-09-24(a)(1), (c)(2), (d)

A doctor’s statement that a claimant is “disabled” or “unable to work” is not a medical opinion under 20 C.F.R. § 404.1527(a)(1). See 20 C.F.R. § 404.1527(d). Consequently, neither Dr. Anderson’s nor Dr. Pickett’s statement concerning Ms. Thompson’s ability to work is due controlling weight under 20 C.F.R. § 404.1527(c)(2).

Law changed since Same change as noted above.

Section 404.1527 provides that a medical source’s statement that a claimant is disabled or unable to work is an issue reserved to the Commissioner and is not entitled to special significance.

Lemon v. Commissioner of the Social Security Administration · filed 2020-01-28(d)(1), (d)(3)

As to Plaintiff’s argument regarding the opinions of Plaintiff’s providers that she was “medically disabled” or unable to work, the law is clear that they need not be given any heightened value by the court. See 20 C.F.R. § 404.1527(d)(1), (3) (a statement that the applicant is “disabled” or “unable to work” invades the province of the Commissioner and does not have “any special significance”).

Law changed since Same change as noted above.

Section 404.1527(d)(1) reserves the ultimate determination of disability to the Commissioner, so a physician's statement that a claimant is permanently disabled is not controlling.

Post v. Commissioner Social Security Administration · filed 2020-09-29(d)(1)

The ALJ properly rejected the opinion to the extent Dr. Guastadisegni stated that Plaintiff is permanently disabled, because the ultimate determination of disability is an issue reserved to the Commissioner. Id.; 20 C.F.R. §§ 404.1527(d)(1), 416.927(d)(1).

Law changed since Same change as noted above.

Section 404.1527(d) treats opinions about whether a claimant is disabled or unable to work as administrative findings reserved to the Commissioner, rather than medical opinions.

Seibert v. Saul (CONSENT) · filed 2020-10-01(d)

Opinions on some issues, such as whether a claimant is disabled or unable to work “are not medical opinions . . . but are, instead, opinions on issues reserved to the Commissioner because they are administrative findings that are dispositive of a case; i.e., that would direct the determination or decision of disability.” 20 C.F.R. §§ 404.1527(d); 416.927(d); Bell v. Bowen, 796 F.2d 1350, 1353-54 (11th Cir. 1986).

Law changed since SSA’s August 1, 1991 revision moved § 404.1527 to evaluation of medical opinions, so its earlier consultative-examination rule is historical; Since March 27, 2017, § 404.1527 applies to claims filed before that date; § 404.1520c governs evaluation of medical opinions for later claims (82 FR 5844).

The regulation permits the Secretary to find that a claimant is not disabled when the claimant fails or refuses to undergo a required examination without good cause.

Neumerski v. Califano · filed 1981-05-12

The regulations in effect at the time the Appeals Council rendered its decision provided “... if any .. . individual fails or refuses to present himself for any examination or test, such failure or refusal, unless the Secretary determines that there is good cause therefore, shall be a basis for determining that such individual is not under a disability.” 20 C.F.R. § 404.1527 (1970). ... Accordingly, plaintiff had no right to have his attorney present at the ordered psychological examination.

Law changed since Same change as noted above.

Section 404.1527 permits the Secretary to determine that a claimant is not disabled when the claimant fails or refuses to undergo a reasonably noticed physical or mental examination without good cause.

Kaminski v. Califano · filed 1979-01-04

Upon reasonable notice of the time and place thereof, any individual alleged to be under a disability shall present himself for and submit to physical or mental examinations or tests, at the expense of the Administration, by' a physician or other professional or technical source designated by the Administration or the State agency authorized to make determinations as to disability. If any such individual fails or refuses to present himself for any examination or test, such failure or refusal, unless the Secretary determines that there is good cause therefore, shall be a basis for determining that such individual is not under a disability. ... The Regulation is a valid interpretation of the Social Security Act. ... Finally, there is nothing in the administrative record to indicate that plaintiff had “good cause” not to undergo the examinations.

Law changed since Since March 27, 2017, § 404.1527 applies to claims filed before that date; § 404.1520c governs evaluation of medical opinions for later claims (82 FR 5844).

A medical source's statement that a claimant is disabled or unable to work does not mean that the Commissioner will determine that the claimant is disabled, because that determination is reserved to the Commissioner.

Rios v. Commissioner of Social Security · filed 2020-09-08(d)(1)

“A statement by a medical source that [a claimant is] ‘disabled’ or ‘unable to work’ does not mean that [the Commissioner] will determine that [the claimant is] disabled.”

Law changed since Same change as noted above.

Section 404.1527 provides that broad, conclusory medical opinions on whether a claimant is disabled are not determinative of the disability decision.

Kirk v. Secretary of Health and Human Services · filed 1981-12-22

These broad conclusory formulations, regarding the ultimate issue which must be decided by the Secretary, are not determinative of the question of whether or not an individual is under a disability. 20 C.F.R. § 404.1527 (1981).

Law changed since Same change as noted above.

Section 404.1527(e)(1) treats a physician’s opinion about whether a person should receive disability benefits as not being a medical opinion.

Fernandez v. Massanari · filed 2001-06-28(e)(1)

A physician’s opinion about whether a person should receive disability benefits is not a medical opinion. 20 C.F.R. § 404.1527(e)(1). Therefore, the ALJ did not err in disregarding the statement.

Law changed since Same change as noted above.

The regulation does not give controlling weight to a medical source’s opinion that a claimant is disabled because that legal determination is reserved to the ALJ.

KOISCH v. Astrue · filed 2009-08-20(e)(2)

Importantly, a statement by any medical source indicating that a claimant is disabled or unable to work is not determinative of a claimant’s disability status under the law and is not entitled to automatic controlling weight or special significance. 20 C.F.R. § 404.1527(d)(2); Soc. Sec. Reg. 98-5p, 61 Fed.Reg. 34, 471, 24,474 (1996). Whether a claimant is disabled within the meaning of the Social Security Act is a legal conclusion reserved to the ALJ. 20 C.F.R. § 404.1527(e)(2).

Law changed since Same change as noted above.

Section 404.1527(e) does not require an administrative law judge to adopt a medical source's conclusion that a claimant is disabled.

Ferrante v. Astrue · filed 2010-11-29(e)

First, of course, an administrative law judge is never required to adopt the conclusion of any medical source that a claimant is disabled, 20 C.F.R. § 404.1527(e), 416.927(e), which is the practical effect of a finding at Step 3 that the claimant’s impairment meets the terms of a Listing.

Law changed since Same change as noted above.

Section 404.1527(e) makes a treating source’s opinion that a claimant is disabled or unable to work non-controlling because the ultimate disability determination is reserved for the Commissioner.

Ambrosini v. Astrue · filed 2010-07-23(e)

A medical statement or opinion expressed by a treating source on a matter reserved for the Commissioner, such as a statement that the claimant is “disabled” or “unable to work,” is not dispositive or controlling.

Law changed since Same change as noted above.

Section 404.1527(d)(3) means that a physician's opinion that a claimant is unable to work receives no special significance because the agency decides whether the claimant meets the statutory definition of disability.

Cunningham v. Commissioner Social Security · filed 2012-12-13(d)(3)

In addition, an ALJ does not give any “special significance” to a physician‟s opinion that a patient is unable to work because the agency is responsible for determining whether a claimant meets the statutory definition of disability. See 20 C.F.R. § 404.1527(d)(3). Here, Moran‟s opinion that Cunningham was unable to work full time was not entitled by regulation to any special significance.

Law changed since Same change as noted above.

Section 404.1527(d)(1) reserves the determination of whether a claimant meets the statutory definition of disability to the Commissioner, so a medical-source statement that the claimant is disabled or unable to work does not control that determination.

Ahola v. SSA · filed 2017-06-01(d)(1)

And, determining whether claimant is disabled is an issue reserved to the Commissioner. See 20 C.F.R. § 404.1527(d)(1) (The Commissioner is “responsible for making the determination or decision about whether you meet the statutory definition of disability. . . . A statement by a medical source that you are “disabled” or “unable to work” does not mean that we will determine that you are disabled.”).

Law changed since Same change as noted above.

Section 404.1527(d) says that an opinion that a claimant cannot work is not entitled to special significance because the disability determination is reserved to the Commissioner.

Ledoux v. SSA · filed 2018-06-12(d)

Opinions even from medical sources that a claimant is unable to work are not entitled to any particular significance because that issue is reserved to the Commissioner. 20 C.F.R. § 404.1527(d); ... Therefore, the ALJ supportably decided that Chauvette’s opinion that Ledoux could not sustain even part-time work was not binding.

Law changed since Same change as noted above.

Sections 404.1527(d)(1) and (d)(3) reserve the determination of disability to the Commissioner, and a medical source’s statement that a claimant is disabled or unable to work does not control that determination.

MCNALLY v. SAUL · filed 2020-10-29(d)(1), (d)(3)

“We are responsible for making the determination or decision about whether you meet the statutory definition of disability. In so doing, we review all of the medical findings and other evidence that support a medical source’s statement that you are disabled. A statement by a medical source that you are ‘disabled’ or ‘unable to work’ does not mean that we will determine that you are disabled.”

Law changed since Same change as noted above.

Section 404.1527(d)(1) leaves the disability determination to the Commissioner, so a medical source’s statement that a claimant is disabled or unable to work is not binding.

Higginson v. Commissioner of Social Security · filed 2021-03-22(d)(1)

“A statement by a medical source that you are ‘disabled’ or ‘unable to work’ does not mean that [the Commissioner] will determine that you are disabled.’”

Law changed since Same change as noted above.

Section 404.1527(d)(1) reserves the determination of whether a claimant meets the statutory definition of disability to the Commissioner.

Hammill v. Saul · filed 2021-03-24(d)(1)

Even if they had made such assertions, the decision as to whether a claimant is disabled is reserved for the ALJ. 20 C.F.R. § 404.1527(d)(1) (“We are responsible for making the determination or decision about whether you meet the statutory definition of disability.”).

Law changed since Same change as noted above.

20 C.F.R. § 404.1527 makes the Secretary, not a treating physician, solely responsible for determining whether a claimant is disabled based on the medical findings.

Watkins v. Richard S. Schweiker, Secretary of Health and Human Services · filed 1982-02-04

Furthermore, Dr. Hazouri’s opinion on the ultimate issue of disability — specifically that Watkins was unable to return to any gainful activity, Record, Volume 2, at 202, 213 — is not dispositive. That determination is made solely by the Secretary based on medical findings. 20 C.F.R. § 404.1527 (1981).

Law changed since Same change as noted above.

Section 404.1527(e) reserves the determination of disability to the Commissioner, so a medical source's statement that a claimant is disabled or unable to work does not determine disability.

Bracciodieta-Nelson v. Commissioner of Social Security · filed 2011-04-27(e)

Further, the determination of disabled status for purposes of receiving benefits-a decision reserved for the Commissioner, only-will not be affected by a medical source simply because it states that a claimant is “disabled,” or “unable to work.” 20 C.F.R. §§ 404.1527(e), 416.927(e).

Law changed since Same change as noted above.

Section 404.1527(d)(1) makes the agency, rather than a medical source, responsible for deciding whether a claimant meets the statutory definition of disability.

Megehee v. Kijakazi (CONSENT) · filed 2022-10-24(d)(1)

Only the agency is “responsible for making the determination or decision about whether [a claimant] meet[s] the statutory definition of disability.”

Law changed since Same change as noted above.

Section 404.1527 requires an ALJ to consider medical opinions with the rest of the relevant evidence and weigh them using factors including the examining relationship, supportability, consistency, and specialization.

Buckley v. Saul · filed 2020-09-24(a)(1), (b), (c)

The relevant social security regulations provide that “medical opinions are statements from acceptable medical sources that reflect judgments about the nature and severity of [a claimant’s] impairment(s), including [their] symptoms, diagnosis and prognosis, what [the claimant] can still do despite impairment(s), and [the claimant’s] physical or mental restrictions.” 20 C.F.R. § 404.1527(a)(1). ... “When weighing each medical opinion, the ALJ must consider whether the doctor has examined the claimant; the doctor’s relationship with the claimant; the medical evidence supporting the doctor’s opinion; how consistent the doctor’s opinion is with the record as a whole; and the doctor’s specialization.” ... Based on its review of the ALJ’s decision and the record, the Court finds that the ALJ properly applied the appropriate standard in evaluating the weight to be accorded to Dr. Demsey’s opinion regarding Buckley’s functional capacity.

Law changed since Same change as noted above.

Section 404.1527 directs ALJs to give greater weight to treating-source opinions and requires them to consider treatment-relationship factors, supportability, consistency, specialization, and other relevant factors when weighing medical opinions.

Maynard v. SSA · filed 2015-10-07(c)(2)(i)-(ii), (c)(3)-(6)

Under the applicable Social Security regulations, the Acting Commissioner, and by extension the ALJ, is directed generally to give the greatest weight to medical opinions from treating sources, less weight to opinions from sources who have only examined the claimant, and the least weight to medical source who have neither treated nor examined the claimant. See 20 C.F.R. § 404.1527(c). ... When determining the amount of weight to give a medical opinion from a treating source, the ALJ is directed to consider the length of the treatment relationship and the frequency of examination, along with the nature and extent of the treatment relationship. See 20 C.F.R. §§ 404.1527(c)(2)(i)-(ii). When assessing any medical opinion, the ALJ should consider supportability through medical signs and laboratory findings, consistency with the record as a whole, the medical source’s specialization, and other factors, such as the source’s understanding of Social Security disability programs and his or her familiarity with information in the claimant’s case file. See 20 C.F.R. §§ 404.1527(c)(3)-(6).

Law changed since Same change as noted above.

Section 404.1527 requires adjudicators to defer generally to medical opinions about impairments and functional restrictions, weigh them using factors such as treatment relationship, consistency, and support, and not credit a physician’s ultimate conclusion that the claimant is disabled or unable to work.

Lopez v. Colvin · filed 2016-07-11(a)(2), (c), (c)(2)-(6), (d)(1)

The Commissioner is responsible for determining whether a claimant meets the statutory definition of disability, and need not credit a physician’s conclusion that the claimant is “disabled” or “unable to work.” 20 C.F.R. § 404.1527(d)(1). But the Commissioner generally must defer to a physician’s medical opinion, such as statements concerning the nature or severity of the claimant’s impairments, what the claimant can do, and the claimant’s physical or mental restrictions. § 404.1527(a)(2), (c). ... In determining how much deference to give a physician’s medical opinion, the Ninth Circuit distinguishes between the opinions of treating physicians, examining physicians, and non-examining physicians. ... Generally, an ALJ should give the greatest weight to a treating physician’s opinion and more weight to the opinion of an examining physician than to one of a non-examining physician. ... 20 C.F.R. § 404.1527(c)(2)-(6) (listing factors to be considered when evaluating opinion evidence, including length of examining or treating relationship, frequency of examination, consistency with the record, and support from objective evidence).

Law changed since Same change as noted above.

Section 404.1527(c) does not require the agency to specifically reference every listed factor when evaluating medical opinion evidence.

Harris v. Colvin · filed 2014-08-15(c)

The agency was not required to specifically reference each factor listed in 20 C.F.R. § 404.1527(c).

Law changed since Same change as noted above.

Section 404.1527 requires the ALJ to weigh medical opinions by considering the examining-source preference, resolving conflicts, and factoring in supportability and the source’s familiarity with the record.

White v. Commissioner of Social Security Administration · filed 2013-09-10(c)(4), (d)(3), (d)(6), and (e)(2)

Further, while the regulations state that the Commissioner will “[generally, ..give more weight to the opinion of a source who has examined you than to the opinion of a source who has not examined you,” the ALJ is the one who has a duty to evaluate all of the medical opinions in the record and resolve any conflicts. 20 C.F.R. §§ 404.1527(c)(4) & (e)(2). The regulations also state that the supportability of an opinion, as well as the extent to which a source is familiar with a claimant’s other medical information of record, should also be factored into the decision of how much weight to ascribe to a medical source. 20 C.F.R. §§ 404.1527(d)(3) & (6).

Law changed since Same change as noted above.

Section 404.1527 makes physicians’ conclusions non-determinative and requires the Secretary to review the medical findings and other evidence before reaching a final conclusion.

Little v. Schweiker · filed 1982-11-22

The opinions of Drs. Gordon, Houser, and Wilson need not be conclusive on the issue of disability. 20 C.F.R. § 404.1527 states that the conclusions of a claimant’s physicians are not determinative and that the Secretary will review the medical findings and other evidence before making a final conclusion. Where, as here, the medical evidence appears to be conflicting, it is for the Secretary, not this court, to resolve such conflicts.

Law changed since Same change as noted above.

Section 404.1527 makes a physician’s conclusory statement nonbinding and gives it weight according to its clinical support and consistency with the other evidence.

Edwards v. Heckler · filed 1983-10-17

A conclusory statement of disability is, of course, not binding on the Secretary. 20 CFR § 404.1527 (1982). The weight to be given a physician’s conclusory statement depends on the extent to which it is supported by specific and complete clinical findings and is consistent with other evidence on the severity and probable duration of the individual’s impairments. ... Here, Claimant’s initial impairments were documented with an electromyogram, a myelogram and a discogram. Tr. at 110-119. No such objective medical findings support Dr. Carsner’s statement and no comparison between Dr. Carsner’s examination results and Claimant’s initial condition of disability has been made to demonstrate how Claimant’s condition is improved.

Law changed since Same change as noted above.

Section 404.1527 does not make a treating physician’s conclusory opinion dispositive; the determination of disability remains the Secretary’s prerogative.

Christine HOUSTON, Plaintiff-Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant-Appellee · filed 1984-06-14

Ultimately, the determination of disability is the prerogative of the Secretary, not the treating physician, and the brief conclusory letter from appellant’s treating physician, was not dispositive of the issue. Kirk v. Secretary of Health and Human Services, supra at 538; 20 CFR § 404.1527 (1981).

Law changed since Same change as noted above.

Section 404.1527 gives the administrative law judge discretion to determine the weight of a claimant’s medical reports, and opinions unsupported by clinical findings may be given little weight.

Poulin v. Heckler · filed 1984-09-07

The AU is vested with discretion to determine the weight to be given a medical report concerning a claimant. 20 C.F.R. § 404.1527. Mere opinions, unaccompanied by clinical findings, may not be ignored, but may be accorded little weight in the exercise of the AU’s discretion.

Law changed since Same change as noted above.

Section 404.1527 provides that physicians' opinions that a claimant is disabled or unable to work do not bind the Secretary.

Maddox v. Heckler · filed 1984-12-28

Statements by physicians that a claimant is disabled or unable to work are not binding on the Secretary, 20 C.F.R. § 404.1527.

Law changed since Same change as noted above.

Section 404.1527 treats objective medical diagnoses and observations as more important than a doctor's conclusions, which do not bind the ALJ.

Noah v. Heckler · filed 1985-12-17

The objective diagnoses and observations are the most important part of the reports, as the doctor’s conclusions are not binding on the AU.

Law changed since Same change as noted above.

Section 404.1527 requires substantial weight for doctors' medical findings, but not for opinions about the actual availability of jobs.

Loya v. Margaret M. Heckler, Secretary of the Department of Health and Human Services · filed 1983-06-16

The ALJ was required to give substantial weight to the doctors’ medical findings, not to their opinions about the actual availability of jobs for a person of limited physical ability and education.

Law changed since Same change as noted above.

Section 404.1527 reserves disability determinations to the Secretary but requires the ALJ to consider physicians' opinions as evidence.

Wilson v. Louis W. Sullivan, Secretary, Department of Health and Human Services · filed 1992-03-10

Decisions of disability, however, are the responsibility of the Secretary and not of doctors. 20 C.F.R. § 404.1527. Nevertheless, the ALJ must consider such evidence. Id.

Law changed since Same change as noted above.

Section 404.1527 places responsibility for deciding disability with the Secretary, while requiring the ALJ to consider physicians' opinions.

Markarian v. Secretary of Health and Human Services · filed 1992-05-11

The ALJ considered and rejected several physicians' opinions that Markarian was unable to perform gainful work due to physical and mental disabilities. However, decisions of disability are the responsibility of the Secretary and not of doctors. 20 C.F.R. § 404.1527 (1991). Nevertheless, the ALJ must consider such evidence. Id.

Law changed since Same change as noted above.

Section 404.1527 is a valid, non-arbitrary framework that Social Security adjudicators may use to evaluate medical opinions in disability cases.

Aldrich v. Sullivan · filed 1992-08-13

For example, new § 404.1527 is titled “Evaluating medical opinions about your impairment(s) or disability.” Therefore, the Secretary has the authority to issue these regulations, and have his adjudicators use them, and we must accept these regulations unless we find them to be arbitrary and capricious. ... Having read the regulations through, we cannot say that they are arbitrary and capricious.

Law changed since Same change as noted above.

Section 404.1527 permits the ALJ to obtain additional medical evidence and requires medical opinions to be evaluated and weighed rather than automatically given controlling weight.

Revels v. Secretary of Health & Human Services · filed 1994-01-14(c)(3)

The ALJ did not find the treating source’s opinion to be controlling in this case. However, the ALJ did exercise her authority under 20 C.F.R. § 404.1527(c)(3), and requested a list of work restrictions from plaintiffs cardiologist and another consultative examination before she made her decision. ... The AIJ specified that she did not accept Dr. Currie’s or Dr. Beilson’s opinions, and also gave reasons for not accepting their opinions. This Court concludes that the ALJ’s analysis was proper, and given that the final determination of disability is the prerogative of the Secretary’s, the Court does not find that the ALJ’s decision was reversible error.

Law changed since Same change as noted above.

An ALJ may reject a treating physician’s opinion when contradictory medical evidence exists and may assign it more or less weight based on the supporting explanation and whether the physician is a specialist.

Serody v. Chater · filed 1995-09-14(d)

An ALJ may reject a treating physician’s opinion on the basis of contradictory medical evidence, and may afford a medical opinion more or less weight depending upon the degree to which supporting explanations for it are provided and whether the treating doctor is a specialist.

Law changed since Same change as noted above.

Section 404.1527(d) requires an administrative law judge to evaluate every medical opinion received.

Burgess v. Chater · filed 1996-09-17(d)

The administrative law judge is required to “evaluate every medical opinion” he receives. 20 C.F.R. § 404.1527(d).

Law changed since Same change as noted above.

Section 404.1527 requires an ALJ assessing conflicting medical opinions to consider the physician's treatment relationship, specialty, and the opinion's consistency and supportability.

Dweaine BOOKS, Plaintiff-Appellant, v. Shirley S. CHATER, Commissioner of Social Security, Defendant-Appellee · filed 1996-08-01(a)-(d)

In assessing conflicting medical opinion evidence, AL Js must consider a variety of factors, including whether a physician is a treating or examining physician; the length, nature, and extent of the treatment relationship; the physician’s specialty; and the consistency and supportability of the physician’s opinion. 20 C.F.R. §§ 404.1527(a)-(d), 416.927(a)-(d).

Law changed since Same change as noted above.

Section 404.1527(d) requires an ALJ to evaluate every medical opinion received.

Tolbert v. Chater · filed 1997-02-11(d)

The ALJ is required to “evaluate every medical opinion” he receives, 20 C.F.R. § 404.1527(d), and to “consider all relevant medical evidence of record in reaching a conclusion as to disability,” Baker v. Bowen, 886 F.2d 289, 291 (10th Cir. 1989).

Law changed since Same change as noted above.

Section 404.1527 permits consideration of opinions from non-physician medical and treating sources, with weight determined by the treatment relationship, supporting evidence, consistency with the record, and the source’s expertise.

Stephens v. Callahan · filed 1997-07-22(d)

The ALJ and the court are not prohibited from considering the opinions of non-physician health care providers by the regulation cited by the Commissioner, 20 C.F.R. § 404.1527. Section 404.1527 refers to medical and treating sources, rather than physicians. However, the weight accorded an opinion will depend on a number of factors, including: length of treatment relationship, nature and extent of treatment relationship, the existence of relevant evidence to support the opinion, the consistency of the opinion with the record as a whole, and the area of expertise or specialty of the treating source.

Law changed since Same change as noted above.

Section 404.1527 requires the ALJ to evaluate all medical opinions and explain why a treating physician's opinion is not entitled to controlling weight.

Sullivan v. SSA · filed 1997-08-28(d)

On remand, the ALJ shall evaluate all of the medical opinions presented to him, not just that of Dr. Adams. If the ALJ determines that any of the medical opinions of plaintiff's treating physicians are not entitled to controlling weight, his explanation for such determinations shall meet the reguirements of 20 C.F.R. § 404.1527(d).

Law changed since Same change as noted above.

The regulation requires the ALJ to evaluate every medical opinion and gives a treating physician’s opinion controlling weight when supported by clinical and laboratory diagnostic techniques and not inconsistent with other substantial evidence.

Knight v. Chater · filed 1997-12-10(d)(2)

The ALJ is required to “evaluate every medical opinion” he receives, 20 C.F.R. § 404.1527(d), and to “consider all relevant medical evidence of record in reaching a conclusion as to disability,” Baker v. Bowen, 886 F.2d 289, 291 (10th Cir. 1989). A treating physician’s opinion about the nature and severity of a claimant’s impairment will be given controlling weight if it is supported by clinical and laboratory diagnostic techniques and is not inconsistent with other substantial evidence in the record. See 20 C.F.R. §§ 404.1527(d)(2), 416.927(d)(2); Castellano, 26 F.3d at 1029.. Anything less is error which this court has censured on numerous occasions.

Law changed since Same change as noted above.

Section 404.1527(d) requires the Commissioner to evaluate every medical opinion received, regardless of its source.

Rufino v. Apfel · filed 1998-04-17(d)

Pursuant to its own regulations, the Commissioner must evaluate every medical opinion it receives, regardless of its source.

Law changed since Same change as noted above.

Section 404.1527 requires an ALJ evaluating conflicting medical evidence to consider factors including the treatment relationship, the physician's specialty, and the opinion's consistency and supportability.

Hanson v. Kenneth S. Apfel, Commissioner of Social Security, 1 · filed 1998-07-28(a)-(d)

The ALJ also must consider factors such as "the length, nature, and extent of the treatment relationship; the physician's speciality; and the consistency and supportability of the physician's opinion." Id. (citing 20 C.F.R. §§ 404.1527(a)-(d), 416.927(a)-(d)).

Law changed since Same change as noted above.

Section 404.1527(d) requires the Commissioner to evaluate every medical opinion and gives a well-supported treating physician's opinion controlling weight unless it is inconsistent with substantial evidence.

Gonzalez v. Apfel · filed 1999-08-25(d)

Pursuant to SSA regulations, the Commissioner must evaluate every medical opinion received, regardless of its source. ... Evaluation of medical evidence is governed by the “treating physical rule,” which states that the treating physician’s opinion as to the claimant’s disability, even if retrospective, is controlling if it is well-supported by medically acceptable techniques and is not inconsistent with substantial evidence in the record.

Law changed since Same change as noted above.

Section 404.1527(d) requires an ALJ to evaluate every medical opinion he receives.

Flores v. Apfel · filed 2000-11-13(d)

The ALJ is required to “evaluate every medical opinion” he receives, 20 C.F.R. §§ 404.1527(d), 416.927(d), and to “consider all relevant medical evidence of record in reaching a conclusion as to disability,” Baker v. Bowen , 886 F.2d 289, 291 (10th Cir. 1989).

Law changed since Same change as noted above.

Section 404.1527 permits an ALJ to determine a claimant’s RFC from the record as a whole and to give less weight to an opinion that is inconsistent with the source’s clinical findings or the record.

Daniels v. Apfel · filed 2000-11-29(d)(4), (e)(2)

First, the ALJ has sole responsibility for determining appellant’s RFC, including his mental RFC, based upon the record as a whole. 20 C.F.R. § 404.1527(e)(2); see also SSR 96-8p, 1996 WL 374184, at *4-5. Second, the PRT form is a psychiatrist’s opinion, and the ALJ is not bound by conclusions expressed in such an opinion to the extent those conclusions are inconsistent with the psychiatrist’s own clinical findings. See 20 C.F.R. § 404.1527(d)(4) (“Generally, the more consistent an opinion is with the record as a whole, the more weight we will give to that opinion”); cf. Castellano v. Sec’y of Health & Human Servs., 26 F.3d 1027, 1029 (10th Cir. 1994) (stating even treating physician’s opinion may be rejected if not supported by specific findings or the evidence).

Law changed since Same change as noted above.

Section 404.1527(c)(3) requires the ALJ to evaluate a medical opinion in light of the record as a whole or recontact the source to resolve ambiguity or inconsistency.

Bibbs v. Apfel · filed 2001-01-19(c)(3)

Even if it were, the regulations call for the ALJ to evaluate Dr. Sikka’s opinion in light of the record as a whole or recontact Dr. Sikka to explain any ambiguity or inconsistency in his opinion. 20 C.F.R. §§ 404.1527(c)(3), 416.927(c)(3).

Law changed since Same change as noted above.

Section 404.1527(d) requires an ALJ to evaluate medical opinions, generally give greater weight to treating sources, give controlling weight to a well-supported and consistent treating-source opinion, and explain the reasons for the weight assigned.

Valdez v. Apfel · filed 2000-07-17(d)

The ALJ is required to evaluate every medical opinion she receives. 20 C.F.R. § 404.1527(d). More weight is generally given to opinions from treating sources. 20 C.F.R. § 404.1527(d). If a treating source’s opinion “is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the] case record, [it] will [be] give[n] controlling weight.” 20 C.F.R. § 404.1527(d); ... The ALJ must give good reasons for the weight given to a treating source’s opinion. 20 C.F.R. § 404.1527(d).

Law changed since Same change as noted above.

Section 404.1527(a)(2) defines medical opinions as statements from acceptable medical sources that reflect judgments about an impairment's nature and severity, including symptoms, diagnosis, prognosis, what the claimant can still do, and physical or mental restrictions.

McKinney v. Barnhart · filed 2003-04-04(a)(2)

The determination of disability rests on medical opinions. Medical opinions are “statements from . . . acceptable medical sources that reflect judgments about the nature and severity of your impairment(s), including your symptoms, diagnosis and prognosis, what you can still do despite impairment(s), and your physical or mental restrictions.” 20 C.F.R. § 404.1527(a)(2). Acceptable medical sources are defined at § 404.1513(a). Medical journal articles are not included as acceptable medical sources. We cannot give persuasive authority to an attorney’s extrapolation of a medical article to his client’s condition. See, generally, Soc. Sec. Rul. 96-5p, 1996 WL 374183, at *4 (clarifying that medical source statements must be submitted by acceptable medical sources and are to be based on the medical sources’ personal knowledge of the claimant). While medical literature can be cited and relied on to support a claimant’s position, it cannot be the only evidence showing disability.

Law changed since Same change as noted above.

Section 404.1527(d) requires an ALJ to apply specified factors when evaluating medical-source opinions.

Cuthbertson v. SSA · filed 2003-06-20(d)

The ALJ must apply the factors provided in 20 C.F.R. § 404.1527(d) to evaluate the opinions of medical sources.2 SSR 96-5P, 1996 WL 374183, * 3 .

Law changed since Same change as noted above.

Section 404.1527 guides the ALJ's evaluation of medical opinions, including the selection of the opinion most informed and consistent with the record.

Winfield v. Barnhart · filed 2003-07-01

The ALJ’s decision was supported by the testimony of every medical expert and by all objective medical tests, both past and present. The ALJ’s process of evaluating the medical testimony followed the guidelines of 20 C.F.R. § 404.1527. The ALJ found that the analysis by Dr. Newman was the most informed and consistent with the record.

Law changed since Same change as noted above.

Section 404.1527(d) and (e) do not make a conclusory doctor’s statement that a claimant cannot work controlling when it lacks medical support, and the ultimate disability determination remains for the Commissioner.

Irizarry-Sanchez v. Commissioner of Social Security · filed 2003-03-31(d) and (e)

Irizarry points to Dr. del Rio’s note stating that Irizarry “can’t work; facial keratitis.” Notwithstanding, this conclusory opinion was not supported medical evidence describing the way in which that condition precluded Irizarry from engaging in any work. ... With respect to the medical evidence, the determination of total disability is an issue reserved for the Commissioner.

Law changed since Same change as noted above.

Section 404.1527(f) requires an administrative law judge to evaluate state-agency physicians' findings as other medical-opinion evidence when assessing residual functional capacity.

Reeves v. Barnhart · filed 2003-05-12(f)

In determining whether a claimant retains the residual functional capacity to perform the requirements of her past relevant work, an administrative law judge must consider any medical opinions from acceptable medical sources which reflect judgments about the nature and severity of the impairments and resulting limitations. ... State agency physicians are experts in the evaluation of the medical issues in disability claims, and administrative law judges must evaluate their findings as they do other opinion evidence.

Law changed since Same change as noted above.

Section 404.1527 requires the ALJ to consider medical opinions from acceptable medical sources that address the nature and severity of impairments and resulting limitations.

Bush v. Barnhart · filed 2003-08-28

The ALJ also correctly noted that the regulations mandate that he consider any medical opinions from acceptable medical sources which reflect judgments about the nature and severity of the impairments and resulting limitations.

Law changed since Same change as noted above.

Section 404.1527 requires an ALJ to evaluate a physician's expert opinion using the regulatory evidentiary factors, without treating substance-use disorders as a probative factor in the initial disability determination.

Brueggemann v. Barnhart · filed 2003-11-03

The ALJ must base this disability determination on substantial evidence of Brueggemann's medical limitations without deductions for the assumed effects of substance use disorders. The inquiry here concerns strictly symptoms, not causes, and the rules for how to weigh evidence of symptoms remain well established. Substance use disorders are simply not among the evidentiary factors our precedents and the regulations identify as probative when an ALJ evaluates a physician's expert opinion in the initial determination of the claimant's disability. See 20 C.F.R. § 404.1527.

Law changed since Same change as noted above.

Section 404.1527(d) identifies five principal factors for evaluating the weight of a medical opinion, including the examining relationship, treatment relationship, supportability, consistency, and specialization.

Doud v. Commissioner of Social Security · filed 2003-10-28(d)

There are five principal factors involved in evaluating the weight of a medical opinion; namely, (1) the examining relationship; (2) the treatment relationship; (3) supportability; (4) consistency; and (5) specialization. 20 C.F.R. § 404.1527(d) (2003). Although Dr. George is not a mental health specialist, it is undisputed that he had examined and treated Doud for over five years. As her long-time physician, he had more experience with Doud’s physical, emotional, and psychological condition than any other health professional. His observations and conclusions were also consistent with the other medical evidence in this case, including the opinions of Laura Alton (psychotherapist), Drs. Ron Melvin and Mumtaz Suleman (psychiatrists), and Dr. George Pestrue (psychologist). Based upon this record, Dr. George’s opinion should have been given “deferential weight.” Magistrate Judge’s Report at 10.

Law changed since Same change as noted above.

Section 404.1527(d)(1)-(6) identifies the factors relevant to evaluating the weight of a medical opinion and does not include a claimant's testimony as a listed reason to reject the opinion.

Higgins v. Barnhart · filed 2003-12-04(d)(1)-(6)

The regulations provide a list of acceptable reasons to reject a doctor’s opinion; the list does not include a claimant’s testimony.

Law changed since Same change as noted above.

Section 404.1527 permits an ALJ to consider and rely on opinions from nonexamining medical sources as opinion evidence, including when weighing conflicting medical opinions.

Moody v. Comm Social Security · filed 2004-11-16(f)

Although it is true that treating physicians are generally given more weight, an ALJ is not foreclosed from relying upon a non-examining physician’s opinion. 20 C.F.R. § 404.1527(d). The Regulations allow the ALJ to rely upon medical opinions and specifically provide that “all evidence from nonexamining sources [is] opinion evidence.” 20 C.F.R. § 404.1527(f).

Law changed since Same change as noted above.

The regulation requires the ALJ to consider six listed factors when weighing a medical opinion.

Brown v. Barnhart · filed 2005-03-24(d)(2)-(6)

In weighing any medical opinion, the ALJ must consider the following factors: (1) the “length of the treatment relationship and the frequency of examination”; (2) the “nature and extent of the treatment relationship”; (3) the amount of relevant evidence supporting the physician’s opinion; (4) how consistent that opinion is with the rest of the record; (5) whether the physician is a specialist; and (6) other factors tending to support or contradict the opinion.

Law changed since Same change as noted above.

Section 404.1527 requires an ALJ to consider medical opinions but allows the ALJ to reject them after evaluating the expert’s specialty, expertise, supporting evidence, and explanations.

Haynes, Richard v. Barnhart, Jo Anne · filed 2005-07-26(f)(2)

While it is true that the regulations require an ALJ to consider opinions offered by medical experts, an ALJ is not bound by those opinions and must evaluate them in the context of the expert’s medical specialty and expertise, supporting evidence in the record, and other explanations regarding the opinion. See 20 C.F.R. §§ 404.1527(f)(2); 416.927(f)(2).

Law changed since Same change as noted above.

Section 404.1527(d) requires adjudicators evaluating medical source opinions to apply the applicable regulatory factors.

Dutil v. Barnhart · filed 2005-12-09(d)

When evaluating any medical source opinion-treating or non treating source, the ALJ is required to consider the factors listed in the regulations. Social Security Ruling 96-5p reaffirms the need for adjudicators to apply the applicable factors in 20 C.F.R. §§ 404.1527(d) and 416.927(d).

Law changed since Same change as noted above.

Section 404.1527 directs courts to weigh medical opinions using factors including examination, treatment relationship, supportability, consistency, and specialization.

Johnson v. Jo Anne B. Barnhart, Commissioner of Social Security · filed 2005-12-12

Courts evaluate and weigh medical opinions pursuant to the following nonexclusive list: (1) whether the physician has examined the applicant, (2) the treatment relationship between the physician and the applicant, (3) the supportability of the physician’s opinion, (4) the consistency of the opinion with the record, and (5) whether the physician is a specialist. 20 C.F.R. § 404.1527 (2005). Courts often accord “greater weight to the testimony of a treating physician” because the treating physician has necessarily examined the applicant and has a treatment relationship with the applicant.

Law changed since Same change as noted above.

Section 404.1527 requires an ALJ evaluating a treating source’s medical opinion to consider and discuss the prescribed factors, even when the opinion is not given controlling weight.

Moore-Gibbon v. Commissioner of Social Security · filed 2021-04-26(c)

The list of factors in § 404.1527 does not exist to occupy space. Indeed, even if an ALJ articulates a good reason for refusing to give a treating source controlling weight, remand can be based on the ALJ’s failure to discuss the “required checklist of factors.” Larson v. Astrue, 615 F.3d 744, 750–51 (7th Cir. 2010). Here, the ALJ failed to consider any factors other than the consistency of Dr. Payne’s opinion. True, this is one of the most important factors. However, the Commissioner points to no authority that permits the ALJ to consider this factor to the exclusion of the others.

Law changed since Same change as noted above.

Section 404.1527(c) requires an ALJ to consider the listed factors—including the examining and treatment relationships, supporting evidence, consistency with the record, and source specialization—when deciding how much weight to give a medical opinion.

Hunter v. Social Security Administration, Commissioner · filed 2021-02-24(c)

To determine the weight to give a medical opinion, an ALJ must consider several factors, including the examining relationship, the treatment relationship, the evidence presented to support the opinion, the consistency of the opinion with other evidence, and the specialization of the medical professional. 20 C.F.R. §§ 404.1527(c), 416.927(c). ... The ALJ stated with particularity the weight he gave Dr. Nichol’s opinion; considered the entire medical record along with that opinion; and found that Dr. Nichol’s opinion was only entitled to some weight. The court finds that the ALJ applied the correct legal standards in assessing Dr. Nichols’ opinion and that substantial evidence supports the weight he gave to that opinion.

Law changed since Same change as noted above.

Section 404.1527(c) requires an ALJ who declines to give a treating physician’s opinion controlling weight to consider the treatment relationship, supporting explanation, consistency with other evidence, and physician specialty.

Love v. Saul · filed 2022-05-23(c)

For claims filed before March 27, 2017, as Plaintiff’s claim was, Section 404.1527(c) of the Social Security regulations provides that if an ALJ does not give a treating physician’s opinion controlling weight, the ALJ must consider the following factors in deciding what weight to give the physician’s opinion: the length, nature, and extent of the treating relationship; the opinion’s supporting explanation and consistency with other evidence; and any specialty of the physician.

Law changed since Same change as noted above.

Section 404.1527(a)(2) treats a medical source who treats or evaluates a claimant and has an ongoing treatment relationship as a treating source at the top of the medical-opinion hierarchy.

Dabney v. O'Malley · filed 2025-03-18(a)(2)

At the top are treating physicians––or medical sources who treat or evaluate the claimant and have an ongoing treatment relationship with her. See 20 C.F.R. § 404.1527(a)(2); Benton ex rel. Benton v. Barnhart, 331 F.3d 1030, 1036–38 (9th Cir. 2003).

Law changed since Same change as noted above.

Section 404.1527(d) directs adjudicators to evaluate medical opinions under six specified factors.

Washington v. Barnhart · filed 2006-01-06(d)

Finally, his decision reflects that he evaluated plaintiffs subjective complaints in accordance with the seven factors specified in 20 C.F.R. § 404.1529(c)(3), and he evaluated Dr. Walkes’s opinions in accordance with the six factors specified in 20 C.F.R. § 404.1527(d). The court, therefore cannot find an error in methodology that might deprive the decision of substantial eviden-tiary support.

Law changed since Same change as noted above.

Section 404.1527 directs decisionmakers to weigh medical opinions using factors including examination, the treatment relationship, supportability, consistency with the record, and specialization.

Johnson v. Barnhart, Comm · filed 2006-01-26

Courts evaluate and weigh medical opinions pursuant to the following non-exclusive list: (1) whether the physician has examined the applicant, (2) the treatment relationship between the physician and the applicant, (3) the supportability of the physician’s opinion, (4) the consistency of the opinion with the record, and (5) whether the physi-cian is a specialist. 20 C.F.R. § 404.1527 (2005).

Law changed since Same change as noted above.

Section 404.1527(d) requires an ALJ to consider specified factors when evaluating medical opinions and explain the weight given to them.

Keys v. Barnhart · filed 2006-04-25(d)

The ALJ properly considered the factors set forth in 20 C.F.R. § 404.1527(d) and explained why she gave more credit to Dr. An’s opinion.

Law changed since Same change as noted above.

Section 404.1527(b) requires medical opinions to be considered together with all the relevant evidence.

Lopez v. Barnhart · filed 2006-06-13(b)

Second, the ALJ properly evaluated Dr. Primer’s opinion in the context of the record as a whole. See 20 C.F.R. § 404.1527(b) (stating that medical opinions must be considered with all the relevant evidence); White, 287 F.3d at 907 (explaining that a treating physician’s opinion should be consistent with other substantial evidence).

Law changed since Same change as noted above.

Section 404.1527 requires an ALJ to evaluate and weigh medical opinions using non-exclusive factors such as examination, treatment relationship, supportability, consistency with the record, and specialization.

Hines v. Jo Anne B. Barnhart, Commissioner of Social Security · filed 2006-07-11

The ALJ was obligated to evaluate and weigh medical opinions “pursuant to the following non-exclusive list: (1) whether the physician has examined the applicant, (2) the treatment relationship between the physician and the applicant, (3) the supportability of the physician’s opinion, (4) the consistency of the opinion with the record, and (5) whether the physician is a specialist.”

Law changed since Same change as noted above.

Section 404.1527 generally gives greater weight to the opinions of examining rather than non-examining physicians, treating rather than non-treating physicians, and specialists in their areas of expertise rather than non-specialists.

Davis v. Jo Anne B. Barnhart · filed 2006-07-21(d)(1), (2) & (5)

Generally, the opinions of examining physicians are given more weight than non-examining, treating more than non-treating, and specialists on issues within their areas of expertise more weight than non-specialists. 20 C.F.R. § 404.1527(d)(1), (2) & (5). ... Having clearly noted the little weight he gave to Doctors Crum and Tocci’s opinions, the ALJ relied on the opinion of Dr. Smith that Davis’s depression was not grave. The ALJ articulated his reasons for discrediting the other evaluating doctors’ opinions, which is supported by the record.

Law changed since Same change as noted above.

Section 404.1527(d) requires an ALJ to evaluate every medical opinion and generally give more weight to opinions from examining sources than from nonexamining sources.

Babcock v. Barnhart · filed 2006-02-06(d)

The regulations inform claimants that “we will evaluate every medical opinion we receive,” and that “[generally, we give more weight to the opinion of a source who has examined you than to the opinion of a source who has not examined you.” 20 C.F.R. § 404.1527(d).

Law changed since Same change as noted above.

Section 404.1527 permits an ALJ to request and consider medical-expert opinions about the nature and severity of a claimant's impairments and whether they equal a listed impairment, but does not require the ALJ to do so.

Hardee v. Commissioner of Social Security · filed 2006-07-25

Social Security regulations permit—but do not require—an ALJ to “ask for and consider opinions from medical experts on the nature and severity of [a claimant’s] impairment(s),” and whether they equal the requirements of a listed impairment.

Law changed since Same change as noted above.

Section 404.1527(d)’s factors for evaluating medical opinions do not apply to an opinion from a consultative examiner who is not a treating physician.

Lewis v. Barnhart · filed 2006-09-26(d)

The factors set forth in 20 C.F.R. § 404.1527(d) are not applicable in this instance because Dr. Scott-Gurnell is not a treating physician.

Law changed since Same change as noted above.

Section 404.1527 treats statements from acceptable medical sources as medical opinions and permits an ALJ to give less weight to an opinion that conflicts with more convincing medical opinions.

Arnold, Steven v. Barnhart, Jo Anne · filed 2007-01-16(a)(2), (d)(2)

While one neighbor testified that he had worked in special education administration for twenty years and “interacted in one way or another . . . with probably 500 people with brain injury,” and the other testified that he had been the Director for Senior Housing and Handicapped Housing for Catholic Charities for approximately twenty years, neither neighbor’s experience qualified either of them to render a medical opinion. See 20 C.F.R. §§ 404.1527(a)(2) (defining “medical opinions” as statements by “acceptable medical sources”), 404.1513(a) (medical sources include physicians, psychologists, optometrists, podiatrists, and qualified speech-language pathologists). ... Because Dr. Hoffman’s opinion was in conflict with the more convincing opinions of the other medical experts, the ALJ was entitled to disregard it. See White v. Barnhart, 415 F.3d 654, 658 (7th Cir. 2005); 20 C.F.R. § 404.1527(d)(2).

Law changed since Same change as noted above.

Section 404.1527 requires an ALJ to evaluate medical opinions and explain the reasons for the resulting determinations well enough to permit meaningful review.

Cohen v. Barnhart · filed 2006-11-17

These regulations set the framework by which an ALJ is to evaluate medical opinions and explain the reasons for his or her determinations in order to allow meaningful review.

Law changed since Same change as noted above.

Section 404.1527 requires medical opinions to be considered and evaluated under the factors specified in the regulations.

Ferran v. Astrue · filed 2007-09-14(d)

Medical opinions must not be ignored, and will be evaluated in accordance with factors contained in the regulations. ... Moreover, the ALJ need not give reasons for rejecting Dr. Preston’s report because he did not reject it.

Law changed since Same change as noted above.

Section 404.1527 requires an ALJ weighing medical opinions to consider factors including the examining and treatment relationships, supportability, consistency with the record, and the doctor’s specialization.

Tina Music Gordon v. Astrue · filed 2007-10-04(d)(1)-(6)

The ALJ considers many factors when weighing medical opinions, including the examining relationship, the treatment relationship, how supported an opinion is, whether an opinion is consistent with the record, and a doctor’s specialization. See 20 C.F.R. §§ 404.1527(d)(1)-(6); 416.927(d)(2-6).

Law changed since Same change as noted above.

Section 404.1527 directs the ALJ to give more weight to treating-source opinions and to consider state-agency medical and psychological consultants' findings as opinion evidence.

Hoffman v. Astrue · filed 2007-12-13

In determining disability, the Commissioner “give[s] more weight to opinions from . . . treating sources, since these sources are likely to be the medical professionals most able to provide a detailed, longitudinal picture of . . . medical impairment(s) and may bring a unique perspective to the medical evidence.” 20 C.F.R. § 404.1527(d)(2). ... Additionally, an ALJ “must consider findings of [non-examining] State agency medical and psychological consultants . . . as opinion evidence, except for the ultimate determination about whether [the claimant is] disabled.” 20 C.F.R. § 404.1527(f)(2)(i). ... Here, the ALJ properly evaluated the medical opinions of Drs. Warriner and Billingsley. Neither of these physicians was a treating physician, and thus their opinions were entitled to less weight than the opinions of Hoffman’s treating physicians. Moreover, the medical records do not support the opinions given by Warriner and Billingsley.

Law changed since Same change as noted above.

Section 404.1527(d) requires the ALJ to evaluate every medical opinion regardless of its source.

Vitela v. Commissioner of the Social Security Administration · filed 2007-08-23(d)

Further, the ALJ had to provide at least some reason supported by substantial evidence for rejecting the opinion of the reviewing DSS physician. See 20 C.F.R. § 404.1527(d) ("Regardless of its source, we will evaluate every medical opinion we receive.”).

Law changed since Same change as noted above.

When a treating-source opinion is not entitled to controlling weight, the Commissioner must still weigh it using the regulatory factors and explain the weight assigned.

Ruff v. Astrue · filed 2007-10-24(d)

No medical opinion may be ignored and, unless a treating source opinion is given controlling weight, all such opinions will be evaluated by the Commissioner in accordance with certain regulatory factors. 20 C.F.R. §§ 404.1527(d), 416.927(d); ... In evaluating medical opinions, an ALJ must first determine whether the treating source(s) opinions are worthy of controlling weight. ... If not, the treating source(s) opinions are “still entitled to deference and must be weighed using all of the factors provided in 20 C.F.R. § 404.1527 and 416.927.”

Law changed since Same change as noted above.

Section 404.1527 requires an administrative law judge to evaluate medical opinions under a regulatory framework that generally gives greater weight to treating and examining sources than to non-treating and non-examining sources.

Pfeiffer v. Astrue · filed 2008-05-30(d)

The commissioner has established a regulatory framework that explains how an administrative law judge is to evaluate medical opinions, including opinions from state agency medical or psychological consultants. 20 C.F.R. §§ 404.1527(d), 416.927(d). Generally, opinions from sources who have treated the plaintiff are entitled to more weight than non-treating sources, and opinions from sources who have examined the plaintiff are entitled to more weight than opinions from non-examining sources. 20 C.F.R. §§ 404.1527(d)(1) and (2), 416.927(d)(1) and (2).

Law changed since Same change as noted above.

The regulation requires the Commissioner to evaluate every medical opinion and consider enumerated factors when weighing it unless a treating-source opinion receives controlling weight.

Quintanilla v. Astrue · filed 2008-06-27(d)

Federal regulations require the Commissioner to evaluate every medical opinion received, regardless of its source. 20 C.F.R. § 404.1527(d). When weighing medical opinions, the Commissioner is required to consider a number of enumerated factors unless he gives controlling weight to the opinion of a treating source.

Law changed since Same change as noted above.

Section 404.1527 permits an ALJ to give less weight to a medical opinion when its findings are inconsistent with other evidence in the record.

Gallagher v. SSA · filed 2009-04-03

Further, the ALJ’s decision not to give weight to M s . Chauvette’s limitation findings was not inappropriate because the findings were inconsistent with other evidence in the record. See 20 C.F.R. § 404.1527. In particular, D r . Jaffe and D r . Cylus found that Gallagher had no manipulative limitations and had greater standing and walking capabilities than found by M s . Chauvette.

Law changed since Same change as noted above.

Section 404.1527(d) requires an ALJ to consider the listed factors when deciding what weight to give a medical opinion, but does not require the ALJ to explicitly discuss every factor if the decision permits meaningful review.

Lauxman v. Astrue · filed 2009-04-15(d)

Nevertheless, the ALJ was still obligated to consider the factors of §§ 404.1527(d) and 416.927(d). Yet contrary to Ms. Lauxman’s contention, his failure to “explicitly discuss all the factors . . . does not prevent this court from according his decision meaningful review.”

Law changed since Same change as noted above.

Section 404.1527(d) requires the ALJ to evaluate every medical opinion, regardless of its source.

Henderson v. Astrue · filed 2009-06-10(d)

The regulations require that every medical opinion will be evaluated, regardless of its source. 20 C.F.R. §§ 404.1527(d), 416.927(d).

Law changed since Same change as noted above.

Section 404.1527 treats as medical opinions statements from acceptable sources that reflect judgments about what a claimant can still do despite impairments or about the claimant's physical or mental restrictions; a statement containing no functional limitations need not be weighed.

Gibson v. Commissioner of the Social Security Administration · filed 2020-03-12(a)

Medical opinions are statements from acceptable sources that reflect judgments about what you can still do despite impairments and about your physical or mental restrictions. 20 C.F.R. § 404.1527. The ALJ did not err in not weighing Dr. Kamel’s statement because it does not appear to be an opinion within the administration’s regulatory definition. Moreover, while Dr. Kamel’s statement is on a form entitled Headaches RFC Questionnaire, it contains no opinion on functional limitations. Even if the ALJ erred in not assigning weight to Dr. Kamel’s statement, such error is harmless where Dr. Kamel did not opine to any functional limitations and no effect on the outcome can be shown.

Law changed since Same change as noted above.

Section 404.1527(a)(1) defines a medical opinion as an acceptable medical source's judgment about the nature and severity of an impairment, including its symptoms, diagnosis, prognosis, remaining abilities, and physical or mental restrictions.

Tajkowski v. Commissioner of Social Security · filed 2020-03-23(a)(1)

Social Security regulations define “medical opinions” as “statements from acceptable medical sources that reflect judgments about the nature and severity of your impairment(s), including your symptoms, diagnosis and prognosis, what you can still do despite impairment(s), and your physical or mental restrictions.” 20 C.F.R. § 404.1527 (a)(1). ... Although most of Dr. Kaiser’s treatment notes do not necessarily reflect “judgments” about Plaintiff’s work capabilities, one note, dated June 21, 2011, states “Disability?” /d. at PagelD#613.

Law changed since Same change as noted above.

Section 404.1527(a) defines medical opinions as judgments by acceptable medical sources about an impairment and its resulting abilities or restrictions, including mental restrictions.

Celestine v. Saul · filed 2020-03-26(a)

“Medical opinions are statements from acceptable medical sources that reflect judgments about the nature and severity of your impairment(s), including your symptoms, diagnosis and prognosis, what you can still do despite impairment(s), and your physical or mental restrictions.” 20 C.F.R. §§ 404.1527(a), 416.927(a). ... Second, a review of Dr. Billings’ mental medical source statement shows that Dr. Billings listed “repeating directions” as a capability that was affected by Plaintiff’s impairments. Tr. 1072. This was an opinion about Plaintiff’s mental restrictions, and thus, the ALJ was required to address this specific functional limitation. 20 C.F.R. §§ 404.1527(a), 416.927(a).

Law changed since Same change as noted above.

Section 404.1527(a)(1) treats as a medical opinion an acceptable medical source’s statement reflecting a judgment about the nature and severity of an impairment, including symptoms, diagnosis, prognosis, remaining abilities, or physical or mental restrictions.

Blankenship v. Commissioner of Social Security · filed 2020-09-24(a)(1)

Plaintiff has not shown, however, that Dr. Nielsen provided a “medical opinion,” as that term is defined in 20 C.F.R. § 404.1527. “Medical opinions are statements from acceptable medical sources that reflect judgments about the nature and severity of [a claimant’s] impairment(s), including [her] symptoms, diagnosis and prognosis, what [she] can still do despite impairment(s), and [her] physical or mental restrictions.” 20 C.F.R. § 404.1527(a)(1). ... Dr. Nielsen did not provide a judgment concerning the nature and severity of Plaintiff’s impairments, her abilities, or her physical restrictions. ... As such, his medical evaluation is not a medical opinion.

Law changed since Same change as noted above.

Section 404.1527(c) requires an ALJ evaluating a contradicted treating or examining doctor’s opinion to apply the listed treatment-relationship and other relevant factors.

Mercado v. Commissioner of Social Security Administration · filed 2021-02-08(c)(2)(i)–(ii) and (c)(3)–(6)

The ALJ must also apply the factors set forth in 20 C.F.R. § 404.1527(c)(2)(i)–(ii) and (c)(3)–(6). ... Here, the ALJ failed to provide the specific and legitimate reasoning required. ... Assuming the ALJ’s reference to “Dr. Beach’s treatment relationship with the claimant” refers to the fact that Dr. Beach did not have an extensive history of treating Claimant, that is but one of several factors the ALJ was required to consider. See 20 C.F.R. § 404.1527(c)(3)–(6).

Law changed since Same change as noted above.

Section 404.1527(c) requires an ALJ weighing medical opinions to consider all regulatory factors, including supportability and consistency with the record.

McClodden v. Commissioner of the Social Security Administration · filed 2024-02-05(c)

Considering the ALJ’s decision and the records relied on by the ALJ, the ALJ properly considered all of the factors for weighing an opinion in 20 C.F.R. § 404.1527(c). The ALJ’s discussion addresses the factors of the supportability and consistency of the source’s opinion with respect to all of the evidence of record.

Law changed since Same change as noted above.

Section 404.1527(c) requires an ALJ who gives a treating physician’s opinion less than controlling weight to consider all of the regulation’s medical-opinion factors, not merely supportability and consistency.

Dorsey v. Kijakazi · filed 2024-08-01(c)

Given all the above, the ALJ erred when, after deciding to give Dr. Guss’s opinion less than controlling weight, he failed to consider any factors under 20 C.F.R. § 404.1527(c) beyond supportability and consistency, and he failed to provide specific and legitimate reasons for rejecting Dr. Guss’s medical opinion.

Law changed since Same change as noted above.

Section 404.1527(d) directs adjudicators to consider specified factors when determining the weight to give a medical opinion.

Lusardi v. Astrue · filed 2009-10-30(d)(1)-(6)

The ALJ did not expressly address all of the factors listed in 20 C.F.R. § 404.1527(d)(1) — (6) in determining the weight to be given to Dr. Zoubek’s opinion regarding Lusardi’s likely excessive absenteeism. However, in his decision, the ALJ specifically stated that he considered the § 404.1527(d) factors. His opinion also shows that he knew Dr. Zoubek was a specialist (urologist), considered the infrequency of Lusardi’s visits to Dr. Zoubek, noted the lack of support for the opinion in the medical records, and found an inconsistency between Dr. Zoubek’s opinion concerning Lusardi’s likely absenteeism and other opinions he had rendered.

Law changed since Same change as noted above.

Section 404.1527 permits greater weight for medical opinions consistent with the record and from specialists in the relevant area, while conclusory disability opinions may be discounted.

Gant v. Commissioner of Social Security · filed 2010-04-07

See 20 C.F.R. § 404.1527(d)(4) (“Generally, the more consistent an opinion is with the record as a whole, the more weight we will give to that opinion.”). ... Because the record adequately supports the finding that Dr. Watson’s medical opinion was not supported by her own treatment notes and was inconsistent with the record as a whole, the ALJ was warranted in discrediting her opinion. ... Conclusory medical opinions are properly discounted as only the Commissioner can make the ultimate determination of disability. See 20 C.F.R. § 404.1527(e)(1). ... See 20 C.F.R. § 404.1527(d)(5) (more weight should be given to a specialist about medical issues to his or her area of specialty than to the opinion of a source who is not a specialist). ... Because Dr. McGee’s medical opinion about sleep apnea was inconsistent with the record as a whole and related to a matter outside his area of expertise, the ALJ was warranted in not accepting his opinion.

Law changed since Same change as noted above.

Section 404.1527(d) directs an ALJ to evaluate medical opinions using specified factors and give good reasons for the weight assigned to a treating source's opinion.

Dumensil v. SSA · filed 2010-08-04(d)

Regardless of its source, we will evaluate every medical opinion we receive. Unless we give a treating source's opinion controlling weight under paragraph (d)(2) of this section, we consider all of the following factors in deciding the weight we give to any medical opinion. ... We will always give good reasons in our notice of determination or decision for the weight we give vour treating source's opinion. 20 C.F.R. § 404.1527(d) (emphasis supplied). ... Given the particular facts of this case, the court concludes that the Administrative Law Judge was obligated to provide a more detailed explanation for his decision to reject the opinions of the physician assistant, Ms. Spelma - the medical professional with arguably the most detailed knowledge of claimant's condition, her treatment, and her response to that treatment. ... Here, the ALJ's reasons for rejecting Ms. Spelma's opinions are not sufficiently detailed to permit meaningful appellate review.

Law changed since Same change as noted above.

Section 404.1527 requires medical opinions to be weighed by considering the examining relationship, supporting objective findings, and consistency with the record as a whole.

O'DELL v. Astrue · filed 2010-09-08(d)

Several factors determine the weight that a medical opinion is due, including (a) the nature, length, and specialty of the examining relationship, (b) the amount of objective medical signs and laboratory findings supporting the opinion, and (c) consistency of the opinion with the record as a whole. 20 C.F.R. § 404.1527. I will analyze these factors in turn.

Law changed since Same change as noted above.

Section 404.1527 requires the ALJ to evaluate a medical consultant's opinion in light of the consultant's qualifications and the medical evidence reviewed before assigning it weight.

Herron v. Astrue · filed 2010-12-22(a)-(e), (f)(2)(ii)

The ALJ also gave “great weight” to the non-treating State agency consultant’s opinion even though the consultant’s identity and specialty were unknown and the consultant did not review a substantial portion of the relevant medical evidence, including the records from Herron’s treating physicians and nurse practitioner. See 20 C.F.R. §§ 404.1527(a)-(e), (f)(2)(ii).

Law changed since Same change as noted above.

Section 404.1527(d) requires an administrative law judge to evaluate medical opinions using relevant factors, including the treating relationship, supportability, consistency, specialization, and other factors bearing on the opinion’s weight.

Sitsler v. Astrue · filed 2011-01-10(d)

Even if a treating physician’s opinion is not entitled to controlling weight, it is still entitled to deference and must be weighed using the relevant factors. See id. The factors include the length, frequency, nature, and extent of the treating relationship; the extent to which the opinion is supported by relevant evidence, particularly medical signs and laboratory findings; the extent to which the opinion is consistent with the record as a whole; the doctor’s specialization; and other factors tending to support or contradict the opinion. See 20 C.F.R. §§ 404.1527(d) and 416.927(d).

Law changed since Same change as noted above.

When a treating physician’s opinion is not entitled to controlling weight, the ALJ must still weigh it using the treatment relationship, examination frequency, supporting evidence, consistency with the record, specialty, and other relevant factors.

Karger v. Commissioner of Social Security · filed 2011-02-10(d)(2)-(6)

Even if the ALJ does not give controlling weight to a treating physician’s opinion, he must still consider how much weight to give it . . . . In doing so, the ALJ must take into account the length of the treatment relationship, the frequency of examination, the extent of the source’s knowledge of the impairments, the amount of relevant evidence supporting the source’s opinion, the extent to which the opinion is consistent with the record as a whole, whether or not the physician is a specialist in the relevant field, and any other relevant factors tending to support or contradict the opinion.

Law changed since Same change as noted above.

Section 404.1527(a)(2) treats a statement about the nature and severity of an impairment as a medical opinion only when it comes from an acceptable medical source; a social worker’s assessment is not a medical opinion that the ALJ must consider.

Dube v. SSA · filed 2011-02-24(a)(2)

Social workers are not “medical sources,” see Anderson v . Astrue, 682 F. Supp. 2d 8 9 , 96 (D. Mass. 2010); see generally, 20 C.F.R. § 404.1513(a)(1)-(5), and therefore do not generate a “medical opinion” that must be considered by an ALJ. See Evans v . Barnhart, N o . 02-459-M, 2003 WL 22871698, at *5-*6 (D.N.H. Dec. 4 , 2003); see generally 20 C.F.R. §§ 404.1527(a)(2), 404.1513(a)(1)-(5), (d)(1).

Law changed since Same change as noted above.

Section 404.1527(d) requires an ALJ to give substantial weight to a treating physician's opinion, diagnosis, and medical evidence unless good cause supports giving it less weight.

Brunson v. Astrue · filed 2011-03-07(d)

Substantial weight must be given to the opinion, diagnosis, and medical evidence of a treating physician unless there is good cause to do otherwise.

Law changed since Since March 27, 2017, § 404.1527 applies to claims filed before that date; § 404.1520c governs evaluation of medical opinions for later claims (82 FR 5844). The 2012 rule moved the former treating-source provisions from § 404.1527(d) to (c) (77 FR 10651).

Section 404.1527(d)(2) gives a treating physician’s opinion controlling weight when it is supported by medical findings and not inconsistent with substantial evidence, and requires good reasons before the opinion is discounted.

Packham v. Astrue · filed 2011-01-04(d)(2)

A treating physician’s opinion is entitled to controlling weight if it is supported by the medical findings and not inconsistent with the other substantial evidence in the record. ... An ALJ must offer good reasons before discounting a treating physician’s opinion.

Law changed since Since March 27, 2017, § 404.1527 applies to claims filed before that date; § 404.1520c governs evaluation of medical opinions for later claims (82 FR 5844).

When a treating physician’s opinion is not well supported or conflicts with substantial evidence, § 404.1527(d) requires the Commissioner to weigh it using specified factors, including the treatment relationship, supporting evidence, consistency with the record, specialization, and other relevant considerations.

Vincent v. Astrue · filed 2010-09-07(d)

In the event the treating physician’s opinion is not well supported or is inconsistent with other substantial evidence, the Commissioner must apply the following factors to determine the proper weight to give the opinion: (1) the length of the treatment relationship and frequency of examination; (2) the nature and extent of the treatment relationship; (3) how much supporting evidence is provided; (4) the consistency between the opinion and the record as a whole; (5) whether the treating physician is a specialist; and (6) any other factors brought to the attention of the Commissioner.

Law changed since Same change as noted above.

A treating physician’s opinion gets controlling weight only when well-supported and consistent with substantial evidence; otherwise, an ALJ may weigh it against the treatment relationship, the record’s consistency, and the physician’s specialty, while explaining the weight given.

LaBreque, Jr. v. SSA · filed 2011-01-28(d)(2), (4), (5)

In the present case, the ALJ did not err by failing to give controlling weight to Dr. Batlivala’s opinion, and giving “substantial weight” to Dr. Ahn’s opinion. First, substantial evidence in the record conflicted with Dr. Batlivala’s opinion, such that his opinion was not entitled to controlling weight. Standing in contrast to Dr. Batlivala’s opinion that claimant could only do less than sedentary work was Dr. Ahn’s opinion, the opinion of the Agency medical consultant, and evidence of claimant’s daily activities. Second, based on factors relevant under the regulations (20 C.F.R. § 404.1527(d)(2), (4),(5)), the ALJ was entitled to discount Dr. Batlivala’s opinion and give greater weight to Dr. Ahn’s opinion, regardless of the fact that Dr. Batlivala was a pain specialist.

Law changed since Same change as noted above.

Section 404.1527 requires the ALJ to evaluate every medical opinion received, and failing to identify a treating source prevents review of whether the required consideration was given.

Dennis v. Commissioner of Social SEC. · filed 2011-03-29(d)

However, the job of the ALJ is to consider all the medical evidence submitted to it. See 20 C.F.R. § 404.1527(d) ("[W]e will evaluate every medical opinion we receive."). When the ALJ fails to mention a treating source by name or even acknowledge that the plaintiff underwent a relevant medical procedure, the Court has no way of determining whether proper consideration was given to the relevant factors in deciding the disability question.